394 Facilitators and barriers to seeking and engaging with antenatal care in high-income countries: a meta-synthesis

Previous studies have associated inadequate attendance to antenatal care with negative maternal and foetal outcomes, including higher risk of stillbirth. The aim this study is identify facilitators barriers in developed countries. A meta-synthesis was undertaken whereby a systematic search conducted six different databases March 2019. Qualitative involving pregnant or post-partum women up 12 months from high income countries that provided data about were sought. Meta-ethnography used facilitate the synthesis data. Fourteen included review. analysis indicates influenced at levels beyond individual. Aspects like sociodemographic factors, difficulties navigating health system, administrative delays, lack flexibility tailored care, constant change carer communication issues healthcare professionals also act as barriers. These influence women’s access knowledge formation womens’ professionals’ beliefs, perceptions emotional processes. perceived balance between benefits, depending on woman’s circumstances, will her decision either seek delay care. reasons why attending are multifactorial any response needs be taken across all society not just focused findings could for intervention policy development addressing issue.